A few decades ago, a kid like my 12-year-old son Schuyler may have been labeled as spacey, absent-minded, creative, forgetful, or lazy depending upon the perspective of the viewer. But by viewing his struggles through the lens of Attention Deficit Disorder (of the Inattentive variety) we’ve been able to better manage our frustrations and devise strategies for addressing the problem.
ADD/ADHD symptoms, like all psychiatric issues, fall on a continuum of severity. Because Schuyler has a mild case, we’ve not invested in the $1000 testing battery, filled out the parent and teacher checklists, nor met with a psychiatrist to discuss medication. Parents of children with more serious and disruptive cases may need to take those steps to chart a course of treatment for their child. I recognize that we are fortunate.
As the second child, Schuyler came into the world wired differently than his older brother. He was incredibly sensitive to nuances of emotion and human interactions. His heightened responsiveness also meant he was overwhelmed by sensory stimulation: too much light or heat or volume sent him into a crying jag. His Dad and I, both psychologists, chalked it up to his DNA; of course, we’d bring a highly sensitive kid into the world.
In elementary school we noticed problems. His teachers would comment that while he performed well in class, he was not good at completing homework assignments and dropped balls academically. Each year his teachers had different interpretations of the problem. His third grade teacher put a positive spin on it: “Lots of gifted kids march to the beat of their own drummer.” (What parent doesn’t like hearing their kid is “gifted”?) His fourth grade teacher viewed him as simply disorganized and worked on developing systems for remembering homework, projects and tests. (I appreciated her pragmatic approach). His fifth grade teacher, a military man, seemed less patient, perhaps viewing him as the undisciplined product of touchy-feely parents.
Schuyler’s self-concept hinged upon the opinions of his teachers, rising and falling based on his slip-ups and the subsequent interpretations and judgments of the key adults in his life. None of them mentioned Attention Deficit Disorder. Perhaps they were being respectful of our profession; perhaps they’d been warned not to diagnose kids. I had a stereotyped notion of the disorder, assuming ADD kids bounced off walls, were loud and difficult to manage. Schuyler was sweet and easy, just forgetful and absent-minded.
But by the end of fifth grade, I was at my wit’s end. Schuyler could not keep up with his things. He'd lose his sweatshirt on the playground the first day he'd bring it to school. In the mornings he’d step over the backpack that had been strategically placed in the middle of the hallway. Day after day he came home without the necessary books for homework or having written down the wrong assignment.
My husband and I tried to temper our reactions, but Schuyler could sense we were frustrated. He wanted us to be proud of him and he’d get very down on himself. Sometimes at night he’d share his fear that he wasn’t as smart as his classmates or he couldn’t handle school.
Finally, I Googled “Symptoms of ADD” and there was a spot-on description of my child. I learned that children with ADD/ADHD may be:
Inattentive, but not hyperactive or impulsive.
Hyperactive and impulsive, but able to pay attention.
Inattentive, hyperactive, and impulsive (the most common form of ADD/ADHD).
Since he was neither hyperactive nor impulsive, I delved into the description of “Inattentive signs and symptoms:"
"It isn’t that children with ADD/ADHD can’t pay attention: when they’re doing things they enjoy or hearing about topics in which they’re interested, they have no trouble focusing and staying on task. But when the task is repetitive or boring, they quickly tune out. Staying on track is another common problem. Children with ADD often bounce from task to task without completing any of them, or skip necessary steps in procedures. Organizing their schoolwork and their time is harder for them than it is for most children. Kids with ADD/ADHD also have trouble concentrating if there are things going on around them; they usually need a calm, quiet environment in order to stay focused."
There was something liberating about this description. I decided to share my discovery with Schuyler. “Schuyler, I think you have ADD.” His reaction? He cried tears of relief, saying, “You finally UNDERSTAND me!” …and now he better understood himself.
Schuyler just completed his first year in middle school, a year of lockers, five different binders, six teachers and multiple classroom changes. It was a year of juggling sports, music and drama, of new friends and new routines.
Thankfully his school focuses on helping sixth graders get organized. His favorite teacher did a daily after school “Backpack Check” to be certain he had the right books. While there were some dropped balls, he made it through without major trauma and without medication.
We realize we’ll need to be vigilant for the next several years. Whenever we got lazy and didn’t check his backpack or look online for upcoming tests, he’d slip into old habits. The new habits are still not established and it’s too easy for balls to get dropped.
Next year we’ll tighten the reigns, easing up when he’s on top of things. Rather than sending him to his room to do homework, we’ll sit with him and check it when he’s done. We’ll get test schedules from the teachers and study with him to reduce his anxiety about being under-prepared.
We’ll also feed him healthy food and be sure he gets to bed at a decent hour. We’ll try not to over-schedule him since he drops balls when he’s juggling too many of them. We’ll better monitor his video game usage since it steals his time and attention from academics.
In other words, we’re going to have to be focused, attentive and conscious parents for a few more years. As tempting as it is to back off, middle and high school will involve more social, extracurricular and technological distracters than ever. By trying to instill good habits now, we hope that he’ll need less external support down the road and may be able to avoid medication in high school or college.
You might be thinking, “Why NOT just put him on Adderall?” While his attention might improve, at this point we believe the costs outweigh the potential benefits for him. He’s already quite thin and we worry about the appetite suppressant quality of stimulants. We don’t want him either losing weight or getting low blood sugars, which can lead to migraines (another downside of his environmental sensitivities). We don’t want to create sleep problems, increase his anxiety, set him up for the energy drop when the dosage wears off, make him prone to future drug addiction, or, worst of all, change his personality.
So for now we are focused on a behavioral approach. Re-wiring his brain from the outside isn’t easy, but it seems like a solid investment of our time and energy.